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Response of brain metastases from breast cancer to systemic chemotherapy.

Abstract

In a prospective, nonrandomized study, the response of brain metastases (BM) from breast cancer to a standard systemic chemotherapy regimen was measured by clinical follow-up and serial computed tomography (CT) scans. Treatment consisted of 4-week courses of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) in 20 patients or 3-week courses of cyclophosphamide, doxorubicin, and 5-fluorouracil (CAF) in 2 patients. Seven patients had previously received CMF or CAF as adjuvant treatment or for progressive systemic disease. Another seven patients had been previously treated for BM with the use of surgery and/or radiation therapy (RT). Based on the results of clinical follow-up and CT scan, a response that lasted at least 6 weeks was seen in 13 patients (59%; 95% confidence interval, 37% to 80%), including 4 of the 7 patients with recurrent BM. Objective tumor regression occurred after two courses of chemotherapy in 76% of the patients who could be examined and after six courses in 47%. The median duration of neurologic remission in the 13 patients was 30 weeks (range, 15 to 66 weeks). The median overall survival time was 25 weeks (range, 2 to 83 weeks). The response rate of systemic disease paralleled the neurologic response. When compared with a matched group of historical control subjects treated with RT alone, chemotherapy induced a higher rate of neurologic response and led to a longer survival time. These results warrant further studies on the use of chemotherapy in BM from breast cancer.

Authors+Show Affiliations

,

Clinical Department, Netherlands Cancer Institute (Antoni van Leeuwenhoek Ziekenhuis), Amsterdam.

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Source

Cancer 69:4 1992 Feb 15 pg 972-80

MeSH

Adrenal Cortex Hormones
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Brain Neoplasms
Breast Neoplasms
Combined Modality Therapy
Cyclophosphamide
Doxorubicin
Fluorouracil
Humans
Methotrexate
Middle Aged
Neoplasm Recurrence, Local
Prospective Studies
Survival Analysis
Tomography, X-Ray Computed

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

1735089

Citation

TY - JOUR T1 - Response of brain metastases from breast cancer to systemic chemotherapy. AU - Boogerd,W, AU - Dalesio,O, AU - Bais,E M, AU - van der Sande,J J, PY - 1992/2/15/pubmed PY - 1992/2/15/medline PY - 1992/2/15/entrez SP - 972 EP - 80 JF - Cancer JO - Cancer VL - 69 IS - 4 N2 - In a prospective, nonrandomized study, the response of brain metastases (BM) from breast cancer to a standard systemic chemotherapy regimen was measured by clinical follow-up and serial computed tomography (CT) scans. Treatment consisted of 4-week courses of cyclophosphamide, methotrexate, and 5-fluorouracil (CMF) in 20 patients or 3-week courses of cyclophosphamide, doxorubicin, and 5-fluorouracil (CAF) in 2 patients. Seven patients had previously received CMF or CAF as adjuvant treatment or for progressive systemic disease. Another seven patients had been previously treated for BM with the use of surgery and/or radiation therapy (RT). Based on the results of clinical follow-up and CT scan, a response that lasted at least 6 weeks was seen in 13 patients (59%; 95% confidence interval, 37% to 80%), including 4 of the 7 patients with recurrent BM. Objective tumor regression occurred after two courses of chemotherapy in 76% of the patients who could be examined and after six courses in 47%. The median duration of neurologic remission in the 13 patients was 30 weeks (range, 15 to 66 weeks). The median overall survival time was 25 weeks (range, 2 to 83 weeks). The response rate of systemic disease paralleled the neurologic response. When compared with a matched group of historical control subjects treated with RT alone, chemotherapy induced a higher rate of neurologic response and led to a longer survival time. These results warrant further studies on the use of chemotherapy in BM from breast cancer. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/1735089/full_citation/Response_of_brain_metastases_from_breast_cancer_to_systemic_chemotherapy_ L2 - http://www.diseaseinfosearch.org/result/960 ER -